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Trauma > Eye Emergencies > Flashcards

Eye Emergencies Flashcards

1
Q

What is a pinhole device used for?

A

Opaque disc with one/more small holes through it - used to test for visual acuity.

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2
Q

What is the opthalmascope used for?

A

Monitor pupil reactions.

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3
Q

What does the fraction indicate on a Snellen chart?

A

Numerator - top number equates to the distance (m). Denominator - position on the chart of the smallest line read by the ‘patient.’ e.g. 6/60 means the subject can only see the top letter when viewed at 6m.

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4
Q

Define the marcus gunn response.

A

When each pupil responds differently when the light is shone into them. Indicates dysfunction in the optic nerve/retina. Pupil dilates when light shone.

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5
Q

State where an extraocular foreign body would be found.

A

Cornea and subtarsal (inner eyelid surface).

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6
Q

State a symptom of an extraocular foreign body.

A

Pain. Foreign body sensation. Reddening of conjunctiva. Reduced visual acuity.

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7
Q

State a treatment for extraocular foreign body.

A

1) Topical anaesthetic e.g. tetracaine, benoxinate, proxymetacaine 2) Remove embedded corneal FB with needle attached to cotton-tipped applicator (CTA)

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8
Q

State 2 signs of an intraocular foreign body.

A

Pain. Eye pain - following explosion. Markers - peaked pupil (pupil comes out), aqueous leak on fluorescein staining (used with blue light). Iridiodialysis - separation/tearing away of iris from ciliary body.

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9
Q

State a cause of corneal abrasion.

A

Poke in the eye.

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10
Q

State a symptom of corneal abrasion.

A

Erythema (inflamed blood capillaries) with edema of eyelids. Severe pain. Pain on light (photophobia). Reduced visual acuity.

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11
Q

State a treatment of corneal abrasion.

A

Chloramphenicol ointment (dilates iris). Pain relief.

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12
Q

State how you would treat a chemical ocular injury.

A

Extraction of fluid then check pH (flush until normal pH 6.5-8.5). Chloramphenicol ointment (antibiotic used to treat bacterial infections). Opioid analgesia.

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13
Q

Define a dendritic ulcer.

A

A form of keratitis (inflammation of the cornea), caused by recurrent herpes simple virus (HSV) infection.

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14
Q

State symptoms of keratitis.

A

Pain. Impaired eyesight. Photophobia (light intolerance). Red eye.

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15
Q

Define the pathophysiology of keratitis.

A

Inflammation of the anterior chamber of the eye (find leukocytic exudate).

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16
Q

State a treatment of keratitis.

A

Antibacterial solutions e.g. levofloxacin, gatifloxacin, moxifloxacin, ofloxacin. Aciclovir (main treatment for HSV).

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17
Q

State a complication of keratitis.

A

Corneal leukoma e.g. scar tissue formation with prescence of corneal vascularisation. Irregular astigmatism e.g. uneven healing of stroma (thickest layer of the cornea). Corneal perforation may result in endopthalmitis (inflammation of intraocular cavities).

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18
Q

State the difference between corneal abrasion and corneal ulcer.

A

Corneal abrasion - fluorescein stain +ve, transparent look, normal contour of cornea, epithelium only.

Corneal ulcer - fluorescein stain +ve, opaque, uneven colour, stroma involvement.

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19
Q

State another name for conjunctivitis.

A

Pink eye.

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20
Q

State a common bacteria associated with keratitis.

A

Streptococcus. Pseudomonas. Enterobacteriacae (including Klebsiella, Enterobacter, Serratia and Proteus). Staphylococcus species.

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21
Q

Define conjunctivits.

A

Inflammation of the outermost layer of white part of eye.

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22
Q

State a symptom of conjunctivitis.

A

Pain. Burning. Scratchiness. Itchiness.

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23
Q

State 2 causes of conjunctivitis.

A

Bacteria. Viral.

24
Q

State a characteristic of bacterial conjunctivitis.

A

Normal vision. Starts in one eye and may affect other. Shorter time.

25
Q

State a characteristic of viral conjunctivitis.

A

Usually associated with URTI. Adenovirus common. Usually bilateral. Longer duration (photophobia more severe).

26
Q

State a treatment of conjunctivits.

A

Hourly chloramphenicol.

27
Q

Define anterior uveitis.

A

Inflammation of the middle layer of the eye (includes iris and adjacent tissue (ciliary body)).

28
Q

State a symptom of anterior uveitis.

A

Burning of the eye. Redness of the eye. Blurred vision. Photophobia.

29
Q

State a sign of anterior uveitis.

A

Dilated ciliary muscles. Hypopyon (inflammation of the anterior chamber of the eye).

30
Q

State a treatment of anterior uveitis.

A

Intravitreal antibiotics may be used. Note the hypopyon (exudate rich in white blood cells) should not be drained as offers protection to invading pathogen.

31
Q

Define acute angle-closure glaucoma.

A

Develops when there is drainage in the eye is blocked because iris comes forward (drainage angle closed/eye pressure rises).

32
Q

State a risk factor of acute angle-closure glaucoma.

A

Age > 30 years. Sex women > men. Family history of glaucoma. Hypermetropia (long-sightedness).

33
Q

State a treatment of acute angle-closure glaucoma.

A

Drops. Intravenous injection to the lower eyelid.

34
Q

State a symptom of acute angle-closure glaucoma.

A

Eye pain. Severe headache. Nausea. Blurry.

35
Q

What’s the normal intraocular pressure?

A

12-22 mmHg.

36
Q

Define abnormal retinal correspondence (ARC).

A

Also known as Welder’s flash - inflammation of the cornea caused by ultraviolet radiation.

37
Q

State a symptom of abnormal retinal correspondence (ARC).

A

Red. Painful. Watering.

38
Q

State the 4 types of acute vision loss.

A

Optic neuritis. Central retinal artery occlusion. Central retinal vein occlusion. Temporal arteritis (giant cell arteritis).

39
Q

Define optic neuritis.

A

Inflammation that damages the optic nerve as a result of infection.

40
Q

State a sign of optic neuritis.

A

Pain. Vision loss in one eye. Visual field loss. Loss of colour vision. Flashing lights. Swelling of optic disc (point of exit for ganglion cell axons leaving eye).

41
Q

State a diagnosis of acute vision loss.

A

Red desaturation test - stare at a bright red object with your normal eye only, object appears pink/light red in the affected eye.

42
Q

State a treatment of acute vision loss.

A

Steroid medications to reduce inflammation.

43
Q

Which condition is optic neuritis linked with?

A

Multiple sclerosis.

44
Q

What is the purpose of the central retinal artery?

A

To provide nutrients to the retina of the eye.

45
Q

State a cause of central retinal artery occlusion.

A

Thrombosis. Embolus. Giant cell arteritis. Vasculitis. Sickle cell disease. Trauma.

46
Q

State a sign of central retinal artery occlusion.

A

Fundoscopic exam - cherry red spot with surrounding pale retina (pale colour - ischaemia of retina). Afferent pupil defect. Eyelid oedema.

47
Q

State a treatment of central retinal artery occlusion.

A

Ocular massage (15s of pressure). IV acetzolamide (to reduce intraocular pressure).

48
Q

Define central retinal vein occlusion.

A

When the main vein draining blood out of the retina becomes blocked.

49
Q

State a cause of central retinal vein occlusion.

A

High blood pressure. Diabetes. High cholesterol. Smoking. Glaucoma. Oral contraceptive.

50
Q

State a symptom of central retinal vein occlusion.

A

Blurred vision - fluid builds up in the retina (water-logged) leading to macular oedema and damage light receptors at central retina (macula).

51
Q

State one thing you’d find from a central retinal vein occlusion.

A

Diffuse retinal haemorrhage (blood and thunder appearance). Cotton wool spots. Optic disc oedema.

52
Q

State a treatment of central retinal vein occlusion.

A

Steroid implant e.g. dexamethasone. Anti-vascular endothelial growth factor (anti-VEGF drugs) e.g. Lucentis (Ranibizumab), Aflibercept, Avastatin.

53
Q

Define temporal arteritis (giant cell arteritis).

A

Inflammatory disease causing narrowing/blocking of blood vessels to interrupt blood flow.

54
Q

Who is temporal arteritis common with?

A

Women. Aged 50 or over. Autoimmune diseases (body attacks own temporal arteries).

55
Q

State a presentation of temporal arteritis.

A

Headaches. Double vision. Tenderness of scalp/temple. Dizziness. Fever/anorexia. Jaw pain.

56
Q

State a diagnosis of temporal arteritis.

A

ESR and CRP elevated. Temporal artery biopsy (giant cell arteritis.

57
Q

State a treatment of temporal arteritis.

A

Corticosteroid.

Trauma (15 decks)

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